Individual
BRYAN GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1111 SW 28TH ST, OKLAHOMA CITY, OK 73109
(405) 201-6097
Mailing address
1111 S.W. 28TH ST., OKLAHOMA CITY, OK 73109
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
12/12/2013
Last updated
12/12/2013
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